EMCrit Podcast
EMCrit 356 - More on Accidental Hypothermia with Ken Zafren
Aug 29, 2023
Expert guest discusses accidental hypothermia and the concept of afterdrop. Controversy and myths surrounding rewarming methods are debunked. Proper management of mildly hypothermic patients and avoiding common mistakes are highlighted. Considerations for hypothermia patients and invasive rewarming strategies are discussed.
12:41
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Quick takeaways
- Afterdrop can occur when a hypothermic person is removed from a cold environment, causing their core temperature to continue dropping due to cooling of the body's mass and the return of cold blood from extremities to the heart.
- Immersing a hypothermic patient in warm water or a hot shower is a common mistake as it can cause vasodilation and a dangerous drop in blood pressure; proper patient handling during extrication is crucial to avoid serious afterdrop.
Deep dives
The Myth of Afterdrop
Afterdrop refers to a continued drop in core temperature after removing a hypothermic person from a cold environment. It occurs due to the cooling of the body's mass and the return of cold blood from the extremities to the heart. Contrary to the myth, it is possible to rewarm the whole patient using a bear hugger or similar forced air warming method in the field. However, caution should be taken to prevent vasodilation in the extremities, as it can lead to ventricular fibrillation. Walking a moderately hypothermic patient in the field can also cause rescue collapse, so they should be kept lying down and provided with warm fluids to slow down the afterdrop.
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